Revolutionizing the Way Health Plans Manage Data
Health plans have a variety of uses for plan benefit information – CMS bid review and approval, Medicare Plan Finder, member materials (such as ANOCs, EOCs, and SBs), customer service, sales, appeals and grievances, claims, and more. Often, this information is housed in multiple locations and managed independently with no centralized source of truth.
The CodySoft® Plan Benefit Package Module® takes medical and prescription drug benefit data and transforms it into member-facing text in a structured format that is usable enterprise-wide. It transforms the way health plans manage medical and drug benefit data because CMS Health Plan Management System (HPMS) PBP tool data, and other data, is directly imported from multiple sources and stored in one centralized location.
Keep benefit information up-to-date without having to manage multiple data inputs. Gain tight version control and thus a centralized source of truth for all plan benefit information.
With the Plan Benefit Package Module®, You Can:
- Mitigate compliance risk from manual benefit grid maintenance
- Leverage automation to save time and money
- Import PBP xml reports and companion data, define the data structure and rules to auto-transform the data, and export the PBP Reports and Master Data Grids as Excel and PDF files
- Easily retrieve a real-time enterprise-wide data grid to support contract tables, Low Income Subsidy (LIS) tables, marketing tables, operational data and more
- Ensure accuracy in member marketing and communications materials (such as ANOCs, EOCs, and SBs)
- Access a Medicare Plan Finder preview in a format that allows for easy reviews
- Increase consistency between PBP descriptions of benefits and call center benefit scripts
- Enhance claims processing through a system configuration that verifies that the claim programming matches the approved benefits
- Delegate set-up, testing and monitoring of claims processing
- Enhance the product design process through reports and tracking of benefit trends and costs